# TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDIATIO NFIL EFOLDE R
SAID# : .^^^-5^ 3 Date : d.\^ii^\Cf i Address : l^Qf b PmJt ^"V " Remediatio nContractor : Coasta l Environmenta l Group
_ Year : 200 8
SOI LREMEDIATIO N PROPERT YFIL EFOLDE RDOCUMENT S 

# y Vide o o f property (DVD ) Executiv eSummary 

# y EPA-provide dproperty sketc h Signe dAcces s Agreemen t fo r subjec t property Signe dAcces s Agreement(s ) fo r adjacent property 5 / 

## Restoratio nAgreemen t Settlement document s (i.e. , fo r damag e or to replac e plants , etc. ) Confirmatio ndata Photograph s V^^.^JjJjJlM^dh.cX ^ PiL!l£xia}rLa a'3dd ^ -^ruai-S<5c L As-buil t sketc h Satisfactory restoratio nsigne db y Property Owner Property close-ou t chec k lis t signe db y EP A Descriptio no f area s no t meetin g RO D cleanu p criteri a Utility clearance s 5

/ Property informatio nfro mDougla s Count y Assessor' s Offic e 

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Propert yAcces s Checklis t Propert yID : 3737 3 

### Property Address : ^ ^ Q ^ Pr- Q f^ n nWORK STARTE D WOR K

COMPELTED ON : ON : / / / / '
OwncM- : ­^ Address : / 

### lr.ec(i,\c \ Renter : Phone : Fax :
Phone : Cell/Pager : Additiona l Information : Pax : Ccll/Pager : 1 D 0 0 ONotificatio n Lette r

Acces. s Agreemen t Restoratio n Agreemen t Top.soi l Samplin g (i fap|>lical)lc ) Sent : / / Signed : 7 / 30 / OS " Signed: ? 1'^ 1 ^ 1 1 By : 

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Omah a Lea d Sit e

# Propert y I D # Propert y Address : Initia l Contact : Secon dContact : Fina l Contact : Final Action :

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## Dougla s Count y Account Informatio n Pag e 1 o f 4 >xma l
Dougla s County , Nebrask a Propert yRecor d - R152989000 0 Prin t Repor t Parce l Dimension s availabl e @ scal e 0-5 0 f t west o f14 4 S

t -ViewO H Ma p Informatio n i s vali d a s o f2008-4-1 7 Treasurer' s Ta xRepor t Ne wFeatur e ^ - > - •Aut o Sale s Searc h Owne r^. ^

6CJU y EXTO LMORTGAG E SERVICE S IN C P^yT-ATCCL I
1110 3 PLU M D R #30 3 URBANDAL E I A50322-633 3 Propert yInformatio n Ke yNumber : 298 9 000 0 1 5 Accoun t Type : Residentia l I i Parce l Number : 152989000 0 Parce l Address : 180 5 PRAT TS T OMAH AN E 68110-000 0 Lega l Description : KOUNTZ E PLAC E LO T2 BLOC K3 9 W1 0 F TL T1 & E 30F T4 0 X12 5 Valu e Informatio n [ Lan d Improvemen t Tota l 200 7 $4,300.0 0 $25,000.0 0 $29,300.0 0 200 6 $4,300.0 0 $45,500.0 0 $49,800.0 0 200 5 $4,300.0 0 $45,500.0 0 $49,800.0 0 200 4 $4,300.0 0 $10,400.0 0 $14,700.0 0 200 3 $4,300.0 0 $10,400.0 0 $14,700.0 0 200 2 $0.0 0 $0.0 0 $0.0 0 Sale s Informatio n Sale s Date : 2007-09-0 5 Dee d Type : TR D Book : 200 7 Page : 10229 4 Price : $75,000.0 0 Grantor : Jolle yJoh n J J R truste e Grantee : Exto l Mortgag e Service s Valid/Invalid : Invali d Exclusio n Reason : Sal e t o Mortgag e - Ban k Sale s Date : 2006-12-1 2 Dee d Type : W D Book : 200 6 Page : 14102 6 Price : $140,000.0 0 Grantor : Hansmeye rWayn e ! 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R152.
. . 5/8/200 8

## Dougla s Count y Accoun t Informatio n Pag e 2 of4 >rma t

Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : 

### Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Ramire z I -ui s Invali d Multipl e 521-Part i In t Vali d 2006-12-0 8 W D Book : 200 6 Page : 14102 7 $0.0 0 Hansmeye rNorma n VETA L Lui s Ramire z Invali d Multipl e 52 1 Part ! In t Invali d 2005-03-1 7 Q C M $ 30,000.0 0 Constanc e Hansmeye r Wayn e Hansmeye r Invali d Famil ySal e 2003-05-2 8 W D M $ 85,000.0 0 Erwi n Investment s Wayn e Hansmeye rEta l Invali d Multipl e Parce l Sal e 2001-06-2 9 Q C $ 27,000.0 0

Invali d Famil ySal e 1998-09-0 9 D Book : 200 5 Page : 05733 2

Soo* ; 200 3 Page : 10575 2

Book : 218 4 Page : 32 9

Soo* : 2 10 1 Page : 72 0 

## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R152.
. . 5/8/200 8

## Dougla s Count y Accoun t Informatio n Pag e3 of 4 >rma t 

# i

Price : Grantor : $16,000.0 0
Grantee : Valid/Invalid : Exclusio n Reason : Vali d

Sale s Date : Dee d Type : Price : Grantor : 

### 1996-09-1 9 $12,995.0 0 Book : 204 6 Page : 36 9

Grantee : Valid/Invalid : Exclusio n Reason : Vali d

Lan d Informatio n Acre s 0.1 1 S F 5000. 0 Unit s 

### 1. 0 Dept h 125. 0 Widt h 40. 0 Vacan t N o Improvement Buildin g 1 Informatio n

160- 5 Pratt 1 M 2 UHFINISHE D

" O

^• 1 Int W

e-ww l 6 ^ » ? f l pro ? 0 CLIC KT O ENLARG E IMAG E CLIC KT O ENLARG E IMAG E Squar e Footage : 1076. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Goo d

Buil t As : 1 1/ 2 Stor yUnfi n Cond o Squar e Footage : 0. 0 HVAC : Centra l Ai rt o Ai r Rooms : 6. 0 Exterior : Fram e Viny l Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo fCover : Compositio n Shingl e Bedrooms : 2. 0


## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R152.
. . 5/8/200 8

## Dougla s County Accoun t Informatio n Pag e 4 of 4

Roo fType : Gabl e Floorcover : Allowanc e
Yea rBuil t Yea r Remodele d 191 1 0 Detai l Typ e Ad d O n Applianc e Basemen t Fixtur e Fixtur e Porc h Use r Use r Percen t Remodele d 0 % Detai l Descriptio n Fenc e Chai n Lin k Allowanc e Bsmn t Bloc k 8 f t Bas e Fixture s Bat h Ful l En d Soli d Wal l Atti cFul l Finis h Se e note s Stories : 1. 5 Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 Adjuste d Yea r Physica l Ag e Buil t 191 1 9 7 Unit s 1. 0 1. 0 1008. 0 1. 0 1. 0 180. 0 550. 0 1. 0



## http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R152.
. . 5/8/200 8

# D Remot eID iRpag eo f 

# # t Magellan One-Cal l P.O . Box344 8 Tulsa , OK 7410 1 Phon e 918/574-709 8 Fa x 918/574-746 6
Th e following One-Cal l Agencydi g ticket s calle d i n by : Excavator : COASTA L ENVIRONMENTA L SERVIC E Fa xNumber : 877662421 1 Phon e Number : 877662421 0 Fa xDate : 2008/07/3 0 Batchid : 51929 7 Wil l be CLEA R o f undergroun d facilitie s for : MAGELLA NPIPELIN E Stat e Ticke t Numbe r Excavato r Contac t Di g Addres s

N

E 209504 8 ELIZABETH 180 5 PRATT S T
I f you have an yquestions , pleas e contac t Magellan OneCal l a t 918/574-709 8

## Pag e1 of 2

"> Creat e Anothe rTicke t Bac k t o Irt h Interne t Sen d Emai l


## YOU RTICKE TNUMBE RI S 2095048
. Origina l Cal l Date : 7/30/0 8 Time : 3:1 2 p m Op : ELIZABETH1879 0 Wor k t o Begi n Date : 8/01/0 8 Time : 3:4 5 p m State : N E County : DOUGLA S Place : OMAH A Address : 180 5 Street : PRAT T S T Twp : 15 NRng : 13 E Sect-Qtr : 03-SW,10-N W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : lea d remidiatio n Locatio n o f Work : LOCAT E ENTIR E PROPERT Y AL L TH E WA Y T O TH E STREET . Remarks : FAX AL L CLEAR S TO : (877)662-421 1 Compan y: COASTA L ENVIRONMENTA L SERVIC E Contac t Name : ELIZABET H Phone : (877)662-421 0 Wor k Bein g Don e For : coasta l Dept ho f Excavation : 4f t Corne r Lot : N Front : Y Rear : Involve s Tunnelin g o r Horizonta l Borin g : N Explosives : N CXCAT V MAGELLAN MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C

Servic eAre a Contac t Phon eNumbe r Utilit y Typ e 

### Day : 402934046 9 CXCAT V CO XCOMMUNICATIONS , IN C 

### HEID I Alt : 402934046 9 Emerg : 402932975 7 Day : 918574709 8 

## MAGELLA NMAGELLA NMIDSTREA M PARTNER S L P TONYAAlt : Emerg : 918574709 8 

## Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRIC T EDWIN AAlt : 

## Emerg : 402504794 6 Day : 402444719 7 OMAHACO FCITYO FOMAHA-TRAFFIC.SEWE R 

### RO NAlt : 402444516 1 Emerg : 402444516 0 Day : 406728934 3


## http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/30/200 8

## Pag e 2 of 2

Alt : 888728934 3 0PPDGPR 5 OMAH APUBLI C POWE RDISTRIC TN A 

### Emerg : 406728934 3 Day : 406728934 3 QLNN EI C QWES TLOCALNETWOR K 

## NA Alt : 

## Emerg : 888728934 3

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS.
. . 7/30/200 8

## 3237 3 ( ^ 

# As-Buil t Drawin g C OAST AL 

# Omah aLea dSuperfun dSit e EMVIROMHiNTA L C a O U P , IN C

Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e Owne rName : WAYN E AHANSMEYE R 13 ^ Goo d 

### Sit e Sketc h Address : 1805 PRAT T

ST •Poo r Phone : " 402-826-526 0 W: r~) No t pain t Sampl e Nunnbe r RYASCPXA-3237 3 RYBSCPXA-3237 3 RYCSCPXA-3237 3 nYDSCPX A3237 3 Fl F2 81 B? Lea d Concentratio n



## ^33-
. 362
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# a' a LA B 

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## 8Z 5 pp m pp m 

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## D D Date : Time : 

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### -Qff l La b RYASCPLA-3237 3 Resul t 42 6 pp m Numbe rofSample s = 5 

### 1 Staff : 

### yi-iuy '

—I luit i Lcu , r2 : Fron t Right
. Bl = Bac k Left , B2 = Bac k Righ tDZ = Dri p Zone , GZ = Garden , PZ = Play Al l quadrant s ar e as viewe d fro m tti e street , facin g propert y 

### qLS# : 32373 Dat e 

### Excavated : : 0&/20/200 8 Dat e USEP / 

### Signe dOff : 1/13/200 9 Are a Sodde d 124 6 sa ft



## Legen d Concret e Dri p Zon e Excavate d Quadrant s Excavate d Are a replace d wit h Are a replace d wit h 

### Are alef t bar e So d ' ' 

### Rock/Mulc h' ' Contrac t # : EP-R7-07-0 5 Coasta l Environmenta l Grou p Inc
.

# 3237 3
Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e Owne rName : WAYN E AHANSMEYE R [^Goo d 

### Sit e Sketc h Address : 180 5 PRAT TS T •Poor Phone : H : 402-826-5260 w [~~ | No t paint 

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# D Time : I VO ^

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### Staff : />7</ ^ Numbe rofSample s = •5 

## 1 Result 42 6 pp m ^^3^..^
. . > - •.uii i Ldi , r 2 = Fron t Right , B 1 = Bac k Left , B2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden , PZ = Pla y Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y



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### Omah a Lea d Sit e Owne rName : WAYN E AHANSMEYE R (3^Goo d Sit e Sketc h Address : 180 5 PRAT TS T •Poo r Phone : » 402-826-5260 W : |~ | No t paint 

# 1 Sampl e Numbe r Lea d Concentratio n Sampl e Collecte d LA B Firm : Sample s Collecte d RYASCPXA-3237 3 RYBSCPXA-3237 3 F l F 2 3^ 3 362 L pp m

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### I Result 42 6 pp m ^v,av-.,«
. . I - I luii i i-eii , r 2 = Fron t Right , B 1 = Bac k Left , B2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden , PZ = Pla y Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y



## i>c^:.i ^

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# 3237 3 Exterio rPain t Nort h Arro w 

### Omah a Lea d Sit e Owne rName : WAYN E AHANSMEYE R Q^Goo d 

### Sit e Sketc h Address : 180 5 PRAT TS T 

### •Poo r Phone : H : 402-826-526 0 W : Q Not pain t 

# 1 Sampl e Numbe r Lea d Sampl e Sample s Collecte d LA B Concentratio n Collecte d Firm : RYASCPXA-3237 3 F l 

# .^ H pp m Date : RYBSCPXA-3237 3 F2 

# 36 ^ pp m 

# \2 ' 

# n Time : RYCSCPXA-3237 3 B l 

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b RYASCPLA-3237 3 Staff : /^<u y 

### Numbe ro fSample s = 5 

## I Resul t 

### 42 6 pp m ^v,.,w.
. . . - I lui u Lcii , r 2 = Fron t Right , B l = Bac k Left , B2 = Bac k Righ t DZ = Dri p Zone , G Z = Garden , PZ = Pla y Al l quadrant s ar e a s viewe d fro m th e street , facin g propert y

Re v 4 046141012 3K-^^ " ="-</• , .^ W 

### %
. 

# m COASTA L tNVIBONMENTA l cn o u r. IN C 

## Consen t Fo rAcces s T o Propert y RIGH TO F ENTR YT O PREMISE S 

## Granto r(th e propert yowner) consent s t o an d authorize s th e Unite d State s Environmenta l Protectio n Agenc y(EPA ) o rit s authorize d representatives , collectivel y th e Grantee , t o ente ran d perfor m certai n environmenta l respons e activitie s upo n th e followin g describe d premises :

Owner' s Name : Daytim e Phone : 

# y^yy y ^y^Z ^

7T / 

# -^// s
Addres s o fPropert y covere d b ythi s Agreement : 

# /fa' s 

# yyz^^y y PURPOS E O F RESPONS E ACTIVITIE S 

## Th e EPAi s requestin g acces s t o collec t soi l sample s an d remov e soi l tha t contain s elevate d concentration s o flea d an d ma ypos e a healt h hazard
. Th e area(s ) wil l b e excavate d t o remov e contaminate d soil
. Th e remove d contaminate d soi l wil l b e replace d wit h clea n material s an d th e are a wil l b e restore d t o it s origina l condition
. Thi s wor k i s bein g performe d unde rth e Omah a Lea d Superfun d Sit e remediatio n program . Arepresentativ e o fCoasta l Environmenta l Group , contracte d byUSEPA , wil l contact th e Granto rin-perso n t o discus s th e wor k t o b e performed , th e Granto rwil l hav e a n opportunit yt o revie wan d approv e th e planne d soi l removal , an d restoratio n wor k befor e i t begins
. Onc e th e wor k i s finished , th e Granto rwil l b e aske d t o revie wth e wor k an d confir m tha t i t i s complet e an d meet s wit h th e Grantor' s approval
. Upo n completion , th e Granto rwil l receiv e writte n documentatio n fro m EPAtha t th e propert y ha s bee n remediated
.
ENVIRONMENTA LRESPONS E ACTION S 

## B ysignin g thi s Acces s Agreement , th e Granto ri s grantin g th e EPA , it s employees , contractor s an d subcontractors th e righ t t o ente rth e property , at al l reasonabl e time s an d wit h prio rnotice , fo rth e sol e purpos e o fperformin g th e work
. Thi s acces s shal l remai n i n effect unti l th e wor k ha s bee n satisfactoril ycompleted
. Th e Granto rals o agree s to :

Pag e 1 o f25 V^ ^ 

## y . / s V/ COASTA L *>., , _-;0^ ^ ENVtHONMENTA l ' '^o' ^ C •0 U > . I « c



### •Remov e obstruction s includin g boats , trailers , vehicles , playscap e items , woo d piles , do g houses , etc ; •Remov e flowe rbulb s o rplant s tha t th e Granto ro rth e Grantor' s tenan t ma ywis h t o save ; • Wate ran d maintai n replacemen t vegetation , includin g fertilize rapplication , a s necessar ysubsequen t t o a n initia l waterin g perio d b yEPA ; • Abid e b yhealt h an d safet yguidanc e provide d b yEPA ; • I fth e propert yi s rented , assis t EP Ai n obtainin g tenan t approva l fo racces s t o th e propert yt o perfor m th e work
. • Allo wvideotapin g and/o rphotographin g o fth e property
. AGREEMEN TNO TT O INTERFER E 

### Th e Granto ragree s no t t o interfer e o rtampe rwit h an yo fth e wor k activities , o rwit h an y o fth e wor k done , o rwit h th e equipmen t use d o n hi s property , o rt o undertak e an y action s regardin g th e us e o fsai d propert ywhic h woul d ten d t o endange rth e healt h o r welfar e o fth e Grantee s o rth e environment , o rt o allo wother s t o us e th e propert yi n suc h a manner . Shoul d yo u hav e an yquestion s abou t thi s program , pleas e contac t Coasta l Environmenta l Group , a t (712 ) 352-018 8

•I gran t acces s t o m ypropertie s •I d o no t gran t acces s t o m ypropertie s

Signs^m e Date Signatur e Date

d l I woul d lik e t o b e presen t durin g an ysamplin g tha t i s required
.C O AS TA ;_ C HO UPIM C 

# f y (,hV 

# f k Restoratio n Agreemen t Th epurpos eofthi s agreemen t i s t o provid eamutual agreemen t a s t o condition s ofth e propert y prio r t o remediatio nactivities
. Thi s wil l als o serv ea s documentatio nfo r th e purpos e o f assurin g tha t restoratio n activitie s are complete dt o th esatisfactio nofth e property owner an dth eUnite dState s Environmental Protectio nAgenc y (EPA)
.
y ^

y i -X I y ^ 

### Propert y ID : •7 y ^ y 

# y y/ Propert y Address : 

# \id < 

# f^y< ~ Owner : ^ Zf^l^C i Phone : M Q I

## "I HP>' C
O nth eattache ddiagram(s ) indicate area(s ) to e.xcavate danddept ho f e.vcavation
. locationo f all know n utilities , subsuifac efeatures , surfac e structure s an dlandscapin g features , acces s location(s ) t o be usedb y contractor , an dth e directio no f North
. Indicate distances , depths , material types , etc . Indicatedigita l photo s b

y referencin g th e photo-lo g number wit ha narrow indicatin g directio no f view
. 

## Item s T o B e Remove d B yOwne rBefor e Star t O fRemediation : (Us e additiona l sheet s a s necessary ) 'h e removal , storage , disposal , and/o rretur n o fthes e item s i s th e Owner' s responsibility
.

Pag e 1 o f

# m
COASTA L 

## Item s T o B e Remove d B yContracto rDurin g Remediatio n An d No t Replace d (Us e additiona l sheet s a s necessary ) Item : 

# /Af^y ^ fitA-1 ^ P 2 Item : 

# ^Unr/'^b^n y\ii-M^\ ^

\ ^i V i^i^ O ^ — ^ — 1 1 

### Item : / / Item : /
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### / y



## Page 2 oft /C O AS TAI
. fNvinoMnKNTA L 

### Item s T o B e Remove d B yContracto rDurin g Remediatio n An d Replace d (Us e additiona l sheet s as necessary ) Item : / > 

# 1^ / Item : . 

# Y' ^ Item : y. 

# 1 0 ^ y ^ - 1 Item : /
Item : , /
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1 / •

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### Pag e 3 o fCOASTA L 

## Landscap e Inventor y (Us e additiona l sheet s a s necessary ) 

## Ite m Quantit y Uni t Condition/Type/Specie s

Pre-existin g propert yarea , tha t wil l b e excavated , tha t i s covere d wit h grass .

Numbe ro ftree s > 2 inc h trun k diamete r

Numbe ro ftree s ' = 2 inc h 1 iruni < diamete r

Numbe ro fSprini^le r Zones
. Contro l Valves
. 1 Timers
. Heads , etc
. 1 Auac h a sketc h >;! ' lii e

ipririkle: " !i! \ out
.

Numbe ro fan d siz e o f eac h garden / (lowe rbe d area . .••.;.:i;,i ; i ; s.'-.eici' i •.< \ ic.^uw : -•i.'e > ::iiJ
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## Ite m Quantit y Uni t Condition/Type/Specie s Agree dupo nvalu e of plan t material s no t t o b e replace db v contractor . Notethi s valu ewill b e use dt o issu eaplan t \ouche r t o ih epropert > owner . ^ $

Agree dupo nlis t of plant material s that will be replace dby contractor . B e ver y specifi c anddetailed
. Includ easketc h(^i ' uei e eachplant will b eplaced b_

\t!ieconiracio!'
. 

# M Each 1
Agree dupo nareaof properr> ' to bereplace d 1 wit hgras s sod
. 'lii'lud eL i "-kfu:! ! of ihc area(s ) [ o bereplace d'.\'ih •a''as s >.od
. 

# fl

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. 6 •O U F
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### Additiona l Comment s / Instructions : 

# 4 ^



# flK^ f Miyo^ A4i^r

- fti7£iy ^fev9 1^^^^ ^

bfui ^ fe/f ^ / H ]M^th^ ~

n Checl < th e bo xi fOwne rdoe s no t wan t CE G t o documen t interio rfoundatio n wall s an d possibl e pre-existin g damage
. Bycheckin g thi s bo xCE G i s no t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures

.



## 0^ 1 agre e C ] Id o no t agre e

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# 77^ - <:^ ^ l/Ownej ^ Sig i 

## y r y

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.

# BVI D #S ^ Si s XR F PROPERTY SAMPL E SHEE T Dat e 

## H-q o 0 & Addres s 

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# f^ii^Ms ^ Prin t r,.Pj[4lkJ h CMW(y ]

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 264 9 Mod e SOI L Tim e 2008-08-2 0 15:1 2 Duratio n 122.5 7 Sequenc e Fina l Flag s AVERAG E Av g o f2645-264 8 ADDRES S •180 5 Prat t s t QUAD/ZON E P Z INSPECTO R LOPE Z DEPT H ' 6 SAMPL E PT'P E CLEARANC E NOT E

Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 132.02 4 Supervise d By : 

## Certificat e o fVerificatio n

264 5 SOI L 

### 2008-08-2 0 15:0 8 30.2 7 Fina l 3237 3 180 5 Prat t s t P

Z LOPE Z 6 CLEARANC E

± Erro r 

### ± 14.64 1

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E PT'P E NOT E

pp m P b 112.98 1 Supervise d By : 

## Certificat e o fVerificatio n

264 6 SOI L 

### 2008-08-2 0 15:1 0 31.8 5 Fina l 3237 3 180 5 Prat t s t PZ LOPE Z 6 CLEARANC E

± Erro r
± 13.64 1

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E PT'P E NOT E

pp m P b 124.53 9 Supervise d By : 

## Certificat e o fVerificatio n

264 7 SOI L 

### 2008-08-2 0 15:1 1 30.0 2 Fina l 3237 3 180 5 Prat t s t PZ LOPE Z 6 CLEARANC E

± Erro r
± 14.46 3

### ^ 

# Therm o

SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 264 8 Mod e SOI L Tim e 

### 2008-08-2 0 15:1 2 Duratio n 

### 30.4 3 Sequenc e Fina l Flag s BVI D # 3237 3 ADDRES S 180 5 Prat t s t QUAD/ZON E PZ INSPECTO R LOPE Z DEPT H 6 SAMPL E TYP E CLEARANC E NOT E

pp m ± Erro r P b 102.93 7 ± 13.31 7 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 265 4 Mod e SOI L Tim e 2008-08-2 0 15:1 6 Duratio n 121.4 3 Sequenc e Fina l Flag s AVERAG E Av g o f2650-265 3 ADDRES S ' 180 5 Prat t s t QUAD/ZON E easemen t , INSPECTO R LOPE Z DEPT H SAMPL E TYP E 

# a CLEARANC E NOT E

Supervise d B y

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 83.60 0 Supervise d By : 

## Certificat e o fVerificatio n

265 0 SOI L 

### 2008-08-2 0 15 : 1 4 30.5 8 Fina l 3237 3 180 5 Prat t s t easemen t LOPE Z 

### 1 CLEARANC E

± Erro r
± 12.12 5

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 96.66 7 Supervise d By : 

## Certificat e o fVerificatio n

265 1 SOI L 

### 2008-08-2 0 15:1 4 30.2 9 Fina l 3237 3 180 5 Prat t s t easemen t LOPE Z 

### 1 CLEARANC E

±Erro r ±12.88 8

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E PT'P E NOT E

pp m P b 85.48 1 Supervise d By : 

## Certificat e o fVerificatio n

265 2 SOI L 

### 2008-08-2 0 15:1 5 30.2 8 Fina l 3237 3 180 5 Prat t s t easemen t LOPE Z 1 CLEARANC E

± Erro r
± 12.28 0

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 265 3 Mod e SOI L Tim e 

### 2008-08-2 0 15:1 6 Duratio n 

### 30.2 8 Sequenc e Fina l Flag s BVI D # 3237 3 ADDRES S 180 5 Prat t s t QUAD/ZON E easemen t INSPECTO R LOPE Z DEPT H 

### 1 SAMPL E TYP E CLEARANC E NOT E

pp m ±Erro r P b 86.64 0 ±12.29 7 Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 

### 265 9 Mod e SOI L Tim e 

### 2008-08-2 0 15:2 4 Duratio n 

### 120.4 9 Sequenc e Fina l Flag s AVERAG E Av g o f2655-265 8 ADDRES S 180 5 Prat t s t QUAD/ZON E INSPECTO R OPE Z DEPT H 13- ' SAMPL E TYP E CLEARANC E NOT E

Supervise d By :

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 134.16 2 Supervise d By : 

## Certificat e o fVerificatio n

265 5 SOI L 

### 2008-08-2 0 15:2 2 30.0 3 Fina l 3237 3 180 5 Prat t s t D Z LOPE Z 

### 1 3 CLEARANC E

± Erro r
± 14.69 4

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E PT'P E NOT E

pp m P b 107.95 3 Supervise d By : 

## Certificat e o fVerificatio n

265 6 SOI L 

### 2008-08-2 0 15:2 3 30.0 6 Fina l 3237 3 180 5 Prat t s t D Z LOPE Z 

### 1 3 CLEARANC E

± Erro r
± 13.38 1

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 140.71 2 Supervise d By : 

## Certificat e o fVerificatio n

265 7 SOI L 

### 2008-08-2 0 15:2 4 30.0 8 Fina l 3237 3 180 5 Prat t s t D Z LOPE Z 

### 1 3 CLEARANC E

± Erro r
± 15.10 6

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E PT'P E NOT E

pp m P b 133.89 2 Supervise d By : 

## Certificat e o fVerificatio n

265 8 SOI L 

### 2008-08-2 0 15:2 4 30.3 2 Fina l 3237 3 180 5 Prat t s t D Z LOPE Z 

### 1 3 CLEARANC E

± Erro r
± 14.60 9

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1 

## Certificat e o fVerificatio n XL3t-3208 9 Readin g N o 575 3 Mod e SOI L Tim e 

### 2008-12-1 7 17:3 3 Duratio n 

### 121.0 6 Sequenc e Fina l Flag s AVERAG E Av g o f5749-575 2 ADDRES S '180 5 Prat t s t QUAD/ZON E 

## rF i INSPECTO R DEPT H LOPE Z SAMPL E TYP E NOT E CLEARANC E

Supervise d B y

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 15.91 1 Supervise d By : 

## Certificat e o fVerificatio n

574 9 SOI L 

### 2008-12-1 7 17:3 1 30.4 3 Fina l 3237 3 180 5 Prat t s t F l LOPE Z 6 CLEARANC E

± Erro r
± 7.19 2

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 19.21 4 Supervise d By : 

## Certificat e o fVerificatio n

575 0 SOI L 

### 2008-12-1 7 17:3 2 30.3 1 Fina l 3237 3 180 5 Prat t s t F l LOPE Z 6 CLEARANC E

± Erro r
± 7.42 6

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , M A0182 1

XL3t-3208 9 Readin g N o Mod e Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E P/P E NOT E

pp m P b 15.24 8 Supervise d By : 

## Certificat e o fVerificatio n

575 1 SOI L 

### 2008-12-1 7 17:3 2 30.3 1 Fina l 3237 3 180 5 Prat t s t F l LOPE Z 6 CLEARANC E

± Erro r 

### ± 6.96 6

# Therm o SCIENTIFI C Therm o Fishe rScientifi c 90 0 Middlese xTurnpik e Billerica , MA0182 1

XL3t-3208 9 Readin g N o Mode Tim e Duratio n Sequenc e Flag s BVI D # ADDRES S QUAD/ZON E INSPECTO R DEPT H SAMPL E TYP E NOT E

pp m P b 21.83 4 Supervise d By : 

## Certificat e o fVerificatio n

575 2 SOI L 2008-12-1 7 17:3 3 30.0 1 Fina l 3237 3 180 5 Prat t s t F l LOPE Z 6 CLEARANC E

± Erro r
± 7.95 4X 

## Omah a Lea d Site—Fixe d Pric e EP-R7-07-0 5 \ , •^

'^•"•pfto y Coasta l Environmenta l Grou p Inc
. www.coastalhazmat.co m COASTA L ENVmONnENTA L C R O U r. INC 

# EXECUTIV ESUMMARY : BVI D #3237 3 - (180 5 PRAT TST )
N o Issue s o r Concern s Q Issues/Concern s
Detai l Explanation : N O ISSUE S PENDING
.

### - - 

# ^EP A EP APropert y Clos e Ou t For m Propert y# : ^y l ^ Propert yAddress : \ BO- b Pt - ('^-rV V Date/Time : Owner' s Name : Utu,^ ( ^.t.,V(x

. .i r. -\j ^ 

### Quad s Excavaied : P\^ ly^'y ^ ^P'Zr i Contracto rGrou p Cor^^c^-Yi. A"^_^-\v; vO^*" *
Excavatio n Genera l 

### Ye s N o 1
. I fnccessiry , wer e th e correc t quadrant(s ) excavate d an d reslored ? y 2 I fnecessary , wer e (h e correc t areas o fdri p zon e excavate d an d reslored ? i ^ Gradin g So d an d VcceUtio o Ye s N o 1
. Doe s th e gradin g aroun d th e perimeie rofth e hous e i n excavate d areas generall yslop e away . y ^ from th e house ? 2
. Ha s so d bee n lai d i n al l areas that wer e excavated ? 

### ^ 3
. Doe s th e sod appea rl o be generall yhealth yan d growing ? (Onl yevaluat e i finspecte d a t a 3 0 i ^ da ytim e period ) 

### ^ 4 Ar e sodde d areas generall yfirm an d evenl ygraded ? 5 Ar e th e Joint s t^etwee n th e so d strip s generall ytight ? (Onl yevaluat e ifinspecie d a t a 3 0 da y • ^ tim e period ) 

### * ^ 6 Wa s th e propertygrade d suc h tha i wate rwil l not poo l o n th e property' ^

^ y ^ 7 Wa s damag e t o landscapin g o rplan t material s avoided'] ' Gates , Fence s an d ReUinln g Wall s Ves N o 1 D o gate s ope n an d clos e freely? (Ifapplicable ) L ^ 2
. Wer e al l gates o rfence s take n dow n durin g restoratio n activitie s reinstalled ? (Ifapplicable ) 3 Wa s damag e t o gate s o rfence s avoided ? (Ifapplicable ) ly 4
. Wa s damag e t o retainin g wall s avoided ? (Ifapplicable ) 

# iJ k Foundation , Sidin g an d Gullcr s Yes N o 1
. Wa s damag e t o th e sidin g o rtri m avoided ? \y ^ 2 Wa s damag e t o th e foundatio n avoided ? y ^



### . ^ 3
. Wa s damag e t o window s avoided ?

i ^ 4
. Wa s damag e t o window s o rdoo rscreen s avoided ? 5
. Wa s damag e t o downspout s o rdownspou t exiension s avoided ? O ' Sidewalk s an d Driveway s (Concrete ) Ye s N o 1
. Wa s damag e t o drivewa ysurface s avoided ? L ^ 2
. Wa s damag e t o walkwa ysurface s avoided ? 

### ^

# O »ner s comments :

Inspectio nnotes :

L_

i O ^



# Removal andrestoratio naai^'ate s completeincludin g the30-da y so dwarranty : EP ARepresentalivey^^^^^^w^^.^^?^^^*^:^^^^^ ^ Dat ^ //yo f

## Propert yCompletio n Agreemen t
Thi s agieemen l cicicumeni s lli e eoiriplclio n o l remedia l aclivme s perlo i me d n n m ypioperi yM ysignaiur e u'll i designat e tha i 1 a m satisfie d wit h Ih e restoratio n o fm yproperty , an d tha i n o item s ar e i n questions , now , o ra i an\ ' lim e m th e future , excep t Ihos e item s liste d below , ifan y

P'"pc - r yi n 7 ^ J 7 J Propert yAddress : / f'^J ^ ro^t F sJ ^ Qwnc i C-.CKr~a ~ cf C t 

# Ao. ^ ' Phon e 

# 73 1 ou r Restoratio n Item s i n Question :

Item : Item : Item : Item : Item : Item :

\ y \ I a{;rc crc^toratio n i>; completed , rxctp l H S nolt r [ ly^ o fo i aj^ic crestoratio n i. s cornpletcr l 

# 'j^jy^yy m 

# a mimy^liiM
. w ! KI s Sign/wii f Dat e _onlra ( ro i ' s Signatur e Oai c